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目的探讨血小板联合血浆治疗长期口服阿司匹林并高血压性基底节区出血的应用价值。方法 2010年1月至2015年6月收治高血压并长期口服阿司匹林(0.1 g/d或以上;规律服药超过半年)发生基底节区出血86例,均行开颅手术清除血肿,其中45例术前、术中应用血小板及血浆(观察组),41例未应用(对照组)。结果观察组术后出血量[(16.32±3.17)ml]和出血率(19.5%,8/48)均明显低于对照组[分别为(31.87±4.57)ml和(36.5%,15/41);P<0.05]。观察组术后病死率(4.4%,2/45)明显低于对照组(19.5%,8/41;P<0.05)。术后6个月,观察组Barthel评分[(65.27±8.56)分]明显高于对照组[(42.32±5.27)分;P<0.05]。结论长期口服阿司匹林并脑出血患者行手术治疗,术前及术中输注血小板及血浆可显著减少术后再出血的发生,改善患者预后。
Objective To investigate the value of platelet combined with plasma in the treatment of long-term oral aspirin and hypertensive basal ganglia hemorrhage. Methods 86 cases of basal ganglia hemorrhage occurred in patients with hypertension and long-term oral aspirin (0.1 g / d or above; regular medication more than six months) from January 2010 to June 2015. All patients underwent craniotomy for hematoma removal. Of the 45 cases Platelet and plasma were used before and during intraoperative (observation group) and 41 cases were not used (control group). Results The postoperative bleeding volume in the observation group was significantly lower than that in the control group [(16.32 ± 3.17) ml and hemorrhage rate (19.5%, 8/48, respectively] (31.87 ± 4.57 ml and 36.5%, 15/41, ; P <0.05]. Postoperative mortality (4.4%, 2/45) in the observation group was significantly lower than that in the control group (19.5%, 8/41; P <0.05). At 6 months after operation, the Barthel score [(65.27 ± 8.56) points] in the observation group was significantly higher than that in the control group [(42.32 ± 5.27) points; P <0.05]. Conclusion Long-term oral aspirin and cerebral hemorrhage in patients undergoing surgical treatment, preoperative and intraoperative transfusion of platelets and plasma can significantly reduce the incidence of postoperative bleeding and improve prognosis.